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Uworld Step 2 > block 44, 45: ID > Flashcards

block 44, 45: ID Flashcards

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1
Q

Who gets HIV screening?

A

15-65 regardless of risk factors

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2
Q

Preferred HIV screening test

A

4th generation assay

  • confirmatory test: HIV-1/HIV-2 antibody differentiatio immunoassay
  • HIV RNA if first test is negative
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3
Q

Why do we not routine screen for syphilis

A

false positives

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4
Q

do guidelines recommend screening asymptomatic patients for HSV

A

no

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5
Q

what are 3 things to look for in an HIV patient with CMV? What is the CD4 count below

A

CD less than 50

  • retinitis
  • esophagitis
  • colitis
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6
Q

Diagnostic test for CMV colitis in HIV patient

A

colonoscopy with biopsy

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7
Q

clinical feature of HIV patient with cryptosporidium

A

chronic, profuse watery diarrhea

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8
Q

Malaria chemoprophylaxis in areas of high rate of chloroquine resistance

A

atovaquone-proguanil
Doxycycline
Mefloquine

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9
Q

Postexposure HIV prophylaxis treatment

A

3-drug antiretroviral therapy for 4 weeks

- prefer to start treatment in first few hours

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10
Q

Atypical community-acquired pneumonias with GI and central nervous system problems? what bug do I have

A

Legionnaries

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11
Q

how can staph. aureus cause lung problems

A
  • IV drug user
  • tricuspid endocarditis
  • fragments of vegetation can embolize to lungs (cavitary lesions)
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12
Q

where is Chloroquine sensitive

A 
Argentina 
Mexico
Turkey 
Iraq 
Central America 
Caribbean
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13
Q

What is Streptococcus gallolyticus ( S bovis biotype I) is associated with what

A

colonic neoplasms

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14
Q

In humans hepatic hydatid cysts are due to infection with?

A

Echinococcus granulosus

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15
Q

CT of c hepatic hydatid cyst shows

A

eggshell calcification

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16
Q

cutaneous blastomycosis manifests as ?

A

well- circumscribed verrucous nodules and plaques that progress to microabscesses

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17
Q

Patient with diabetes mellitus on INH (isoniazid) is at what risk

A

pyridoxine deficiency: get peripheral neuropathy

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18
Q

Eikenella Corrodens? type of bacteria and where it is found

A

gram-negative anaerobe

normal human oral flora

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19
Q

Enterococi are a common cause of endocarditis associated with

A

nosocomial urinary tract infection

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20
Q

when is 13-valent pneumococcal conjugate vaccine recommended

A

all adults 65 and older followed later by 23-valent pneumococcal polysaccharide vaccine

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21
Q

when is 23-valent pneumococcal polysaccharide vaccine recommended

A
  • less than 65

- smoker, chronic medical condition, heart/lung disease, diabetes, chronic liver disease

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22
Q

what vaccine is given every 10 years

A

Td vaccine

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23
Q

when is Tdap given

A

one-time dose in place of Td for adults

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24
Q

when do you usually test for HSV

A

with patient has active symptoms

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25
Difference between janeway lesions and osler nodes
Janeway: vascular, nontender Osler: Immunologic, painful
26
Laboratory studies for infective endocarditis
normocytic anemia | increase ESR
27
adult still disease
- high fevers - arthritis/arthralgias - salmon-colored macular rash
28
when is PPD test considered positive in an HIV-infected patient
induration is greater than or equal to 5mm
29
how are HIV patients with no manifestations of active TB treated for latent TB?
Isoniazid and pyridoxine
30
how is Babesiosis diagnosed
peripheral blood smear | "Maltese cross"
31
treatment for influenza
most adults without risk factors ( age greater than 65, chronic medical condition) treat symptoms
32
What is the most common secondary complication of influenza and should be suspected in any patient who develops worsening fever or pulmonary symptoms after initial improvment
secondary bacterial pneumonia - Streptococcus pneumoniae - staphylococcus aureus
33
Clinical features of Staph aureus pneumonia? X-ray?
rapid-onset, severe, necrotizing pneumonia with high risk of death - lobar
34
what is the heterophile antibody test for CMV?
negative | - CMV IgM serology is positive
35
What antibiotic covers virulent oral bacteria ( aerobic and anaerobic oral organisms)
Amoxicillin-Clavulanate
36
what does ampicillin cover
gram-positive and gram-negative
37
What does clindamycin cover
gram-positive bacteria and anaerobes
38
What does Ciprofloxacin cover
gram-negative | some gram-positive organisms
39
PE for vertebral osteomyelitis
tenderness to gentle percussion overs spinous process
40
what lab values are elevated in vertebral osteomyelitis
platelets | ESR
41
Miliary tuberculosis Chest-Xray shows
diffuse reticulonodular pattern (millet seed)
42
Most common behavioral risk factor for TB in the US
substance abuse | - other: incarceration
43
causes of toxic shock syndrome
- Menstruation - nasal packing - post surgery infection
44
lab values for toxic shock syndrome
immature neutrophils | thrombocytopenia
45
when is 13-valent pneumococcal conjugate vaccine recommended
- all over 65 followerd by 23-valent pneumococcal polysaccharide vaccine at least 6-12 months later
46
when is PPSV23 recommended
younger 65 with chronic medical condition and smoker | - one time
47
when is tetanus immune globulin given
patients with significant or dirty wounds who have not previously received at least 3 doses of tetanus vaccine or vaccine is uncertain
48
Patients with significant puncture wounds who have not received revaccination for tetanus within how many years should be vaccinated?
5 years
49
lab values for malaria
anemia and thrombocytopenia
50
when can you give live attenuated varicella and MMR vaccines to HIV patients
CD count greater than 200 | titers must be low
51
Lab values for disseminated histoplasmosis? X-ray?
pancytopenia elevated LFTs -reticulonodular infiltrates
52
Treatment for disseminated histoplasmosis in HIV
Amphotericin B | - 1-2 weeks of clinical improvement transition to oral itraconazole for 1 year maintenance
53
cause of epididmyitis for age 35 and older
E. Coli
54
cause of epdidmytis for age less than 35
Chlamydia or Neisseria
55
when do you get imaging for pyelonephritis
no clinical symptoms improvement for 48-72 horus
56
Proteus mirabilis increases the solubility of element in the urine
phosphate | - struvite stones ( magnesium ammonia phosphate)
57
treatment for infective endocarditis for viridans group streptococci
IV aqueous Penicillin G OR IV ceftriaxone for 4 weeks
58
what does ultrasound for Echinococcus granulosus look like
hepatic cyst with daughter cysts ( internal separations)
59
warm, tender, erythematous rash with raised, well-demarcated borders
Erysipelas
60
What causes erysipelas
Group A streptococcus
61
What area of the body suggests erysipelas as this skin lacks lower dermic level
external ear
62
Difference between Td and Tdap
Td: booster Tdap: one-time dose in place of Td
63
For adults age less than 65, with other chronic medical conditions that increase the risk of invasive pneumococcal disease should get what vaccine
PPSV23 alone, followed by sequential PCV13 and PPSV23 at age 65
64
most common cause of community-acquired bacterial meningitis
Streptococcus pneumonia
65
An effective measure for reducing the risk of catheter-associated urinary tract infection in patients with neurogenic bladder
clean intermittent catheterization

Uworld Step 2 (30 decks)

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